中线腰椎融合技术治疗合并骨质疏松的腰椎间盘突出症

目的探讨中线腰椎融合技术治疗合并骨质疏松的腰椎间盘突出症的疗效。方法采用中线腰椎融合技术治疗25例合并骨质疏松的腰椎间盘突出症患者,记录并比较手术前后疼痛VAS评分及JOA评分。结果患者均获得12个月随访。VAS评分:术后1、6、12个月较术前降低,差异均有统计学意义(P<0.01);术后各时间点比较差异均无统计学意义(P>0.05)。JOA评分:术后1、6、12个月较术前升高,差异均有统计学意义(P<0.01);术后各时间点比较差异均无统计学意义(P>0.05)。术后腰痛及下肢症状均得到改善,未发生切口感染或深部椎间隙感染。末次随访时,23例骨性融合,2例未融合,均未发生融合器移位和螺钉松动、退出。结论中线腰椎融合技术治疗合并骨质疏松的腰椎间盘突出症,具有软组织剥离少、出血少、螺钉把持力强、术后并发症少的优点。

Midline lumbar fusion technique for treatment of lumbar disc herniation with osteoporosis

Objective To investigate the efficacy of midline lumbar fusion for lumbar disc herniation with osteoporosis.Methods The 25 patients who suffered from lumbar disc herniation with osteoporosis were treated with midline lumbar fusion technique.The pain VAS,JOA scores at the pre-and post-operation were recorded and compared.Results All patients were followed up for 12 months.VAS:at 1,6,12 postoperation,they were decreased than those before surgery,the differences were statistically significant(P<0.01);there were no significant differences at postoperative various time points(P>0.05).JOA scores:at 1,6 and 12 months postoperation,they were increased than those before surgery,and the differences were statistically significant(P<0.01);there were no significant differences at postoperative various time points(P>0.05).The lumbar pain and lower limb symptoms were improved postoperatively,without incision infection or deep intervertebral space infection.At the last follow-up,there were 23 cases of bony fusion and 2 cases of non-fusion,and no displacement of fusion cage,screw loosening or withdrawal occurred.Conclusions The midline fusion for lumbar disc herniation with osteoporosis has the advantages of less soft tissue dissection,less bleeding,strong control force,and fewer postoperative complications.